The Global Fund Board will not approve funding for Phase 2 of two Round 8 malaria grants to the Republic of Congo.
The Board’s No-Go decision follows notice of an intent to recommend a No-Go for this grant provided by the Global Fund Secretariat in February 2013 (see GFO article). At the time, the Secretariat provided the following reasons for its No-Go intention:
- inadequate programmatic and financial grant performance (a C rating, and an average expenditure rate of 48% for both grants);
- failure to complete a mass distribution of long-lasting insecticide-treated bednets (LLINs), which started in April 2012; and
- failure to complete key activities, such as routine LLIN distribution and the roll-out of rapid diagnostic tests.
In addition, the Secretariat said, data verification exercises revealed that reported data for the number of LLINS distributed to the general population and the percentage of pregnant women who received two or more doses of intermittent preventive therapy were unreliable. Finally, the Secretariat noted, the quality of services provided was poor due to the fact that the guidelines and protocols for malaria diagnosis and treatment were unclear.
The CCM responded to the Secretariat’s concerns on 16 April. Meanwhile, an audit report released by the Office of the Inspector General confirmed that there were major issues regarding the malaria programmes in the Republic of Congo.
The GAC said that although the CCM’s response described a number of actions undertaken and yet to be undertaken by the CCM, the GAC concluded that insufficient guarantees have been provided by the CCM to fully address the concerns raised.
The GAC said that it does not believe that this No-Go decision will imperil access to essential treatments because of a commitment by the Government of the Republic of Congo to spend € 16 million for the continuation of essential services during what would have been the Phase 2 period of the grant.
The GAC said that, in the view of the Secretariat’s country team for the Republic of Congo, the country should use the second half of 2013 to set the foundation for concrete change in the “implementation environment” for malaria programmes. The country team said that this should include (a) the finalisation of the National Malaria Strategic Plan for 2013–2017; (b) the restructuring of the National Malaria Control Programme (NMCP); and (c) transitioning to the revised World Health Organization malaria case management guidelines.
The GAC said that as soon as the National Malaria Strategic Plan is finalised, the CCM and its partners will be supported to initiate a country dialogue and to engage in the preparation of a concept note (for submission early in the full rollout of the new funding model) to cover a potential funding gap for the 2015 LLIN campaign.
The GAC recommended that the country team continue working closely with the Republic of Congo and its NMCP during this period of reprogramming, including exploring different ways of meeting interim needs that may emerge. The GAC said that it was prepared to consider requests for support for some of these interim needs.
Information for this article was taken from Board Decision B28-EDP-28 and from Board Document GF-B28-ER18, the Report of the Secretariat Funding Recommendations for June 2013. The latter document is not available on the Global Fund website. The text of the Board decision will be included in an electronic decisions document to be released after the Board meeting in Sri Lanka (18–19 June).